Breaking Bad (Habits)

2.13am. A downtown loft. In a glitter-esqe façade, rugs of Persia are merely design accents. Down the hall, in a small room full of mirrors, a woman stares at her vanity cabinet. Red pill. Blue pill. Yellow pill. White. How much can I take in one night? A friend raps at the door: “everything okay in there?” A small voice says, “Yes, just taking my medication, give me a sec.” The friend leaves, nodding knowingly. The woman is in pain, after all.

There seems to be a foggy, sexy stigma against prescription pills, or any pills, for that matter – the sort of over-achieving sibling of the drug la familia. According to an article in The Conversation: 'The Therapeutic Goods Administration (TGA) has called for submissions on the idea of deleting Codeine from Schedule 3 (pharmacy only) availability and moving it to Schedule 4 (prescription only).'

This does not come lightly. Studies show Codeine is not as potent without the other components added to make it marketable and therefore 'stronger'. In the Cochrane review, findings showed researchers would need to treat 12 people with 60mg of Codeine alone to achieve a 50% reduction in acute pain for one person. Talk about a Placebo; so I guess it's not Every You, Every Me?

In the Western world, we don't play games with pain the same way we do with pleasure. When it comes to treating pain relief at your GP, the more subjective, the bigger the script can be. Speaking from personal experience with an immediate family member battling mental health (Mellon Collie and the Infinite Sadness, to randomly quote a Smashing Pumpkins song), I have questioned the scripts plenty of times. But I’m reminded of this: who's place is it to say you’re not in enough pain to warrant any medication?

That’s not the purpose of this investigation into Codeine. It's about treating the cause, not the symptom. Having said that, the decision to change how we access Codeine may be a bit of a hassle. Sometimes waiting at the doctor’s office is more of a headache than the actual headache. Wouldn't you want a permanent fix, if possible, instead of the Band-Aid effect of Codeine? I know which one I'd prefer, but I also know what I'd be more likely to do.

When it comes to Class A-Z drugs, prescription and over-the-counter, we’re essentially talking about the same family—the whole clan: cousins, nieces, nephews, and let's not forget any parties who are made accountable by God and the State (the step-mum/dad and whatever step-in-between), y’all included too. These medications are used to alter, magnify or numb pain in the human body. Modern medicine has shown us this, and so has the drug epidemic. Bottom line is this: we do NOT want to be in, stay in, or be subject to possible pain (unless you’re into BDSM; in that case, how you doin'?), but at what lengths and at the cost of whom?

Reports show there are much better alternatives to Codeine containing OTC formulations with a combination dose of 200mg ibuprofen/500mg paracetamol. This was made effective in a head-to-head trial against paracetamol 500mg/Codeine 15mg tablets. The truth is an unsupervised dosage can have serious risks with no real benefits. No doubt a fair share of GPs and hospitals have seen cases of liver damage due to high paracetamol doses. I’ve seen my fair share of overindulgence in pills unfortunately for no other reason but boredom.

Regular Codeine use can cause chronic rebound headaches with difficulties in reducing or stopping the dosage. Countries such as the US, Sweden and Germany have already made the shift from over-the-counter to prescription only. Will there be change from documented harm due to addiction from addictive and non-addictive doses? Only time can tell. It will take more than just a prescription to shift the view society has on the benefits of Codeine. Staff working in pharmacies will not be able to consistently monitor potential substance abusers, because there is no one-size-fits-all expression.

Regardless of whether this is passed in profession is not the point. We need to reevaluate how we see pain and how we deal with it. One white pill here could save a life; another could end it. The choice, undoubtedly, belongs to you. The difference could save you from being a statistic, instead of part of the solution.